A Collaborative Report A Collaborative Report A Collaborative Report A Collaborative Report from from from from

Faculty at the Faculty at the Faculty at the Faculty at the University of Illinois at Chicago University of Illinois at Chicago University of Illinois at Chicago University of Illinois at Chicago

and the and the and the and the City of Chicago Department of Public Health City of Chicago Department of Public Health City of Chicago Department of Public Health City of Chicago Department of Public Health Englewood Neighborhood Health Center Englewood Neighborhood Health Center Englewood Neighborhood Health Center Englewood Neighborhood Health Center

December 2010December 2010December 2010December 2010

“When We Have Better, “When We Have Better, “When We Have Better, “When We Have Better, We Can Do Better”We Can Do Better”We Can Do Better”We Can Do Better”

Family Food Access Report

2

Section Title Section Title Section Title Section Title Page NumberPage NumberPage NumberPage Number

Authors and Acknowledgments 3

Executive Summary 4-5

Introduction 6

Study Description/Methods 7

Background 8-11

Key Findings 12-15

Potential Solutions 16-19

Conclusion/Implications 20

Citation: Odoms-Young A, Zenk S, Holland L, Watkins, A, Wroten J, Oji-Njideka N, Ellis S, Davis I, Dallas C, Fitzgibbon M, Jarrett R, Mason M, Webb A, Sharp D. Family Food Access Report: “When We Have Better, We Can Do Better”. University of Illinois at Chicago and Chicago Department of Public Health-Englewood Neighborhood Health Center. December 2010.

For more information, please contact: For more information, please contact: For more information, please contact: For more information, please contact: Angela Odoms-Young, PhD Assistant Professor Department of Kinesiology and Nutrition University of Illinois at Chicago Phone: 312-413-0797 Email: odmyoung@uic.edu

Table of Contents

3

Authors and Acknowledgments

ContributorsContributorsContributorsContributors University of Illinois at ChicagoUniversity of Illinois at ChicagoUniversity of Illinois at ChicagoUniversity of Illinois at Chicago • Angela Odoms-Young, PhD, College of Applied Health Sciences • Shannon Zenk, RN, PhD, College of Nursing • Constance Dallas, RN, PhD, College of Nursing • Nefertiti Oji-Njideka, BA, College of Applied Health Sciences • Susan Ellis, MBA, College of Applied Health Sciences • Marian Fitzgibbon, PhD, College of Medicine City of Chicago Department of Public Health Englewood Neighborhood Health CenterCity of Chicago Department of Public Health Englewood Neighborhood Health CenterCity of Chicago Department of Public Health Englewood Neighborhood Health CenterCity of Chicago Department of Public Health Englewood Neighborhood Health Center • Loys Holland, Director • April Watkins, MS, PHA III Greater Englewood Healthy Start • Jacqueline Hoskins-Wroten, BSN, MPH (also a DrPH student at UIC-School of Public

Health), Public Health Nursing Supervisor • Angela Webb, WIC Nutritionist Other Contributors Other Contributors Other Contributors Other Contributors • Iona Davis, Teamwork Englewood (formally at University of Illinois at Chicago) • Robin Jarrett, PhD, University of Illinois at Urbana Champaign • Maryann Mason, PhD, Children's Memorial Hospital/Northwestern Feinberg School of Medicine • Darrell Sharp, SGA Youth Services Research Assistants and Interviewers Research Assistants and Interviewers Research Assistants and Interviewers Research Assistants and Interviewers

Sandra Franklin, Carlotta Manns, Knesha Rose, Robin Colbert, Elaine Hardy, Olamide Bamidele, Justine Bandstra, Sarah Leone, Maria Safadi, Dana Woods, Suzie Monsieur, Toni Bush, Hillary Turner, Reginald Riggins, Antoinette Price, Diana Grigsby-Toussaint, Tonya Humphries, Stephanie Brown, Susan Hobson, Jung Kim, Phillip Kramer, Jonathan Fowler, Ursula Redmond, Tonia Humphries, and Summer Porter

We would like to thank: We would like to thank: We would like to thank: We would like to thank:

Dr. Agatha Lowe, PhD, for supporting the project and serving as our CDPH sponsor

The projects highlighted in this report were funded by: The projects highlighted in this report were funded by: The projects highlighted in this report were funded by: The projects highlighted in this report were funded by:

• The Consortium to Lower Obesity in Chicago Children (CLOCC)

• UIC College of Nursing

• The Graduate College at Northern Illinois University

• The African American Collaborative Obesity Research Network AACORN (with a grant received from the Robert Wood Johnson Foundation)

• National Cancer Institute Cancer Education and Career Development Program

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Overview Overview Overview Overview The focus of this report is to better understand food access and availability issues that impact African American families. Evidence suggests that African Americans are espe-cially at risk for suboptimal intakes of healthy foods such as fruits and vegetables, low-fat products, and whole grains; disproportionally at risk for many diet-related health condi-tions; more likely to live in neighborhoods with limited healthy food availability; and a strong target for unhealthy food advertising. Nevertheless, few studies have examined these is-sues from the perspective of the families who are most at risk. This report focuses specifi-cally on understanding the impact of neighborhood food and marketing environments on African American families. The goal of this report is for these families to share their own stories and propose recommendations for community action and policy change. Key FindingsKey FindingsKey FindingsKey Findings • Many of the families indicated that food availability was an issue in their community,

specifically the lack of retail food stores and high-quality food products. Several partici-pants expressed that neighborhood stores should not only offer a wide selection of food options, but provide high-quality goods at reasonable prices. Participants’ perception of their neighborhood food environment varied based on individual/family resources, food preferences, and the locations where they shopped.

• Most participants indicated that they were satisfied with the foods provided at restau-rants in their community. However, many acknowledged neighborhood restaurants mostly provide foods that were high in fat and calories.

• Price was a major concern for families in the study. Food purchasing and access pat-terns were strongly influenced by price. Several participants indicated that they looked at store circulars to determine the locations with the best prices and commonly shopped at discount chains due to lower prices. When participants had extra money, many reported that they purchased food at restaurants but still used special pricing, including the dollar menu or 2-for-1 deals, based on cost.

• Many of the families expressed the need for more black-owned stores and restaurants in their community. Several participants described conflicts between community resi-dents and Arab American store owners. Most participants felt that the conflict was based on store owners’ lack of respect for the community; while a few participants at-tributed some of the responsibility to unruly customers. Some participants mentioned that Arab American store owners who have a long history in the neighborhood, help peo-ple in the neighborhood, and/or embrace African American culture, have a better repu-tation compared to owners overall. Owners with these characteristics were also per-ceived by participants to sell better-quality products.

• Marketing and advertising seemed to influence purchasing mostly through weekly price promotions provided in store circulars, window ads, and/or word of mouth. Although many participants indicated that television ads were entertaining, they did not believe that they had a strong influence on their purchasing habits except when the ads tar-geted children.

Executive Summary

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Key Findings ContinuedKey Findings ContinuedKey Findings ContinuedKey Findings Continued • Participants mentioned the importance of other factors when accessing food including

environments within (e.g., cleanliness, customer service) and around (e.g., safety) res-taurants and stores.

• Participants made several recommendations related to policy change and community action to improve neighborhood food and marketing environments including:

◊ Inform policymakers about the lack of high-quality products in the neighborhood and their impact on health.

◊ Attract food retailers that offer a variety of high-quality food options at a reason-able cost.

◊ Create competition by bringing in new retail stores. ◊ Attract food retailers that provide other amenities, such as delivery services. ◊ Attract food retailers that do not engage in racist/unfair monitoring practices. ◊ Develop more black-owned businesses and identify strategies to reduce conflict between Arab American store owners and community residents.

◊ Reduce crime in neighborhoods to attract more food retail and improve safety around existing retail food outlets.

◊ Offer tax incentives to attract food-related businesses into urban areas. ◊ Change food retailers’ perceptions of South Side residents and communities. ◊ Improve the physical appearance of existing retail food outlets. ◊ Improve customer service by hiring experienced employees and providing better training.

◊ Regulate nutrition content of foods served in restaurants. Conclusion/ImplicationsConclusion/ImplicationsConclusion/ImplicationsConclusion/Implications In the last decade, increasing attention has been given to the need for better food and marketing environments in low-income communities and communities of color. Partici-pants in this study mentioned several concerns related to food access and neighborhood food availability. These issues focused specifically on the types and quality of food retailers and options available, as well as other issues, such as marketing/advertising, customer service, and neighborhood safety. This report demonstrates that community residents have clear recommendations for community action and policy change including attracting new retail options and improving the selection/variety, customer service, and aesthetics of ex-isting retail outlets. Nationally, a number of community/policy efforts have been proposed to address food access and marketing concerns. It is not clear if the issues raised by par-ticipants in this study will be addressed by these efforts. The work of policymakers, commu-nity leaders, advocates, and researchers need to be informed by members of the communi-ties who are most at risk for low food access. In addition, once policy and community ef-forts are implemented, the impact of these strategies on the health and well-being of Afri-can American individuals and families needs to be considered.

Executive Summary

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The relationship between diet and disease is well established. Research generated over several decades has stressed the importance of healthy eating in the prevention of a number of chronic conditions, including diabetes, obesity, heart disease, and many cancers. Despite this body of evi-dence, most Americans fall short of na-tional dietary recommendations to pro-mote health. Scientists and health profes-sionals have long emphasized individ-ual choice as the main influence on purchasing and consuming healthy foods. However, many now acknowl-edge individuals and families cannot make healthy choices if those choices are not readily available in their homes, schools, and neighborhoods. In addition, several research reports have highlighted the role of unhealthy food and beverage marketing in shaping Americans’ decisions about what to eat and drink. With this recognition and growing media attention, phrases such as “food de-serts” (originating in the U.K.) and “food oasis” have become common household terms. For example, “food desert” is defined in the 2008 Farm Bill as an “area in the United States with limited access to affordable and nutritious foods.” Numerous reports and news stories have highlighted inequities in the types of food outlets and food options available in low-income vs. high-income neighborhoods and communities of color compared to pre-dominately white communities. Other terms, such as the “Grocery Gap” proposed by The Food Trust and “Community Food Security” (which has been around since the early 1980s) also have been used to describe racial and socioeconomic disparities in the overall food system and family food access. Moreover, recent studies suggest that low-income popula-tions and communities of color may be exposed to more advertisements promoting un-healthy foods, including fast food and sugar-sweetened beverages such as soda. These issues are particularly salient for African Americans. Evidence suggests that African Americans are especially at risk for suboptimal intakes of healthy foods such as fruits and vegetables, low-fat products, and whole grains; disproportionally at risk for many diet-related health conditions; more likely to live in neighborhoods with limited healthy food availability; and a strong target for unhealthy food advertising. Nevertheless, few studies have examined these issues from the perspective of the families who are most at risk. This report focuses specifically on understanding the impact of food and marketing environ-ments on African American families in their own voices. The goal of this report is for fami-lies to share their stories and propose recommendations for community action and policy change. Lastly, we describe additional policies that have been proposed nationally to pro-mote healthy eating so policymakers, health professionals, and community advocates can consider their potential impact on African American communities in Chicago.

Introduction

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This report highlights the findings from four studies that were conducted as part of a collaborative partnership between faculty at the University of Illinois and staff at the City of Chicago Department of Public Health-Englewood Neighborhood Health Center. These stud-ies were conducted from 2006 to 2010. A total of 103 African Americans living on Chi-cago’s South Side were recruited to engage in a series of ethnographic interviews. Three of the studies also included a photo elicitation, where participants were asked to take photo-graphs of their daily routines. In two of the studies, participants were asked to keep a 7-day diary of the retail locations where they purchased food. Each study was approved by the Institutional Review Board at investigators’ respective institutions. The majority of the participants lived in Englewood and West Englewood (approximately 75%). Other commu-nity areas included Armour Square, Douglas, Fuller Park, Greater Grand Crossing, Ken-wood, New City, Pullman, and South Deering. We specifically targeted residents that pro-vided care for children ages 3-18. Given the need for early intervention, our most recent study also included 5 pregnant women. Whereas the previous three studies only targeted women, our most recent project included 5 men as well. Participants ranged from approxi-mately 21 to 75 years of age. All interviews and field notes were audiotaped, transcribed verbatim, and input into Atlas.ti, a qualitative data management software. A preliminary analysis was conducted using qualitative content analysis which was followed by a more in-depth analysis (constant comparative analysis). All coded data was reviewed to generate themes related to food access and availability to better understand the experiences of community residents. At the end of the most recent study, 9 participants agreed to take a “food tour ” of local grocery stores to explore possible strategies to change the food land-scape in their community. We visited three stores on a chartered bus. Each person was provided a total of $35 to spend during the trip. Participants were interviewed on the bus after visiting each store location.

Study Description/Methods

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Background: Neighborhood Food Availability

• Availability of Stores by Type Availability of Stores by Type Availability of Stores by Type Availability of Stores by Type To better understand the types of food outlets and foods available in our target com-munity, Englewood and West Englewood, we conducted in-person audits at retail stores li-censed to sell food products prior to undertaking the family interviews. In 2006, in-person audits were conducted as part of a larger study examining food avail-ability in Southwest Chicago. Audits were performed using a standard checklist of healthy/unhealthy food options. For this report, we highlighted selected data from four commu-nity areas: Chicago Lawn/West Lawn, Englewood/West Engle-wood, Brighton Park/Gage Park, and New City, to compare communities with different racial composition and socioeconomic characteristics. As seen in previous studies, Englewood/West Englewood had fewer grocery stores and more convenience stores compared to the other three com-munities. However, the number of liquor stores available in Englewood/West Englewood and New City were similar. Figure 1 illustrates the high availability of con-venience stores and low availability of grocery stores in Englewood/West Englewood. For example, data showed that Engle-wood/West Engle-wood had 0.81 grocery stores per 10,000 persons whereas New City had approximately 3.8 grocery stores per 10,000. Moreover, Engle-wood/West Englewood had the greatest number of convenience/corner stores per 10,000 persons.

Englewood/West Engle-

wood

Chicago Lawn/West

Lawn

Brighton Park/Gage

Park

New City

Grocery Store

7 16 22 20

Convenience Store/Corner Store

51 36 25 23

Liquor Store 12 9 5 14

Other 1 11 21 10

Totals 71 72 73 67

Table 1. Number of Stores by Type in Selected Community Areas

1.7 0.82.6 3.8

3.95.9

2.94.4

Chicago Lawn/West

Lawn

Englewood/ West

Englewood

Brighton Park/ Gage Park

New City

Neighborhood Area

Figure 1: Grocery and Convenience Store

per 10,000 Persons

Grocery Store Convenience Store

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Background: Neighborhood Food Availability

• Availability of Store Food Options Availability of Store Food Options Availability of Store Food Options Availability of Store Food Options We also examined availability of selected food items for each community area by store type. Table 2 shows the percentage of stores in each neighborhood that carry se-lected food items.

Englewood West Englewood

%

Chicago Lawn West Lawn

%

Brighton Park Gage Park

%

New City %

Fresh fruit 31 34.7 42.5 44.8

Canned fruit 78.3 76.5 65.8 67.2

Frozen fruit 2.8 6.9 4.1 4.5

Fresh vegetables 43.7 40.3 42.5 46.3

Canned vegetables 90.1 85.9 75.3 85.1

Frozen vegetables 28.2 26.4 17.8 13.4

Skim milk 8.5 15.3 12.3 9

2% milk 56.3 58.3 80.8 77.6

Soy milk 0 6.9 8.2 7.5

Whole milk 83.1 77.8 82.2 85.1

Fat free cheese 0 1.4 2.7 16.4

Reduced fat cheese 2.8 8.3 2.7 6.0

Regular cheese 64.8 59.7 58.9 53.7

Brown rice 11.3 12.5 11 10.4

White rice 81.7 68.1 56.2 70.1

Whole wheat pasta 1.4 2.8 2.7 1.5

White pasta 83.1 72.2 63 79.1

Whole wheat or multi-grain bread

11.3 20.8 56.2 41.8

White bread 77.5 65.3 69.4 82.1

Skinless chicken breast 4.5 12.5 62.5 52.4

Chicken with skin 4.5 15.3 75 66.7

Extra lean or lean ground beef

4.2 6.9 4.1 6.0

Regular ground beef 17.9 25 83.3 95.2

Regular ground turkey 1.5 2.8 8.3 19

Fresh fish 7.5 15.3 54.2 42.9

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Background: Neighborhood Food Availability

As compared to Chicago Lawn/West Lawn, Brighton Park/Gage Park, and New City, fewer stores in Englewood/West Englewood carried fresh fruits and vegetables; frozen fruit; skim, 2%, or soy milk; fat-free cheese; baked potato chips; meat/fish; and whole wheat pasta. In contrast, a slightly greater percentage of stores in Englewood/West Englewood carried canned fruits and vegetables; frozen vegetables; whole milk; regular cheese; regu-lar potato chips; white rice; and white pasta. Most of the stores in Englewood/West Engle-wood that sold fresh fruits and vegetables carried apples, tomatoes and/or green bell pep-pers. As compared to retail stores in the other community areas, a greater percentage of the stores in Englewood/West Englewood carried fresh vegetables that were consistent with a traditional African American cultural diet. For example, about 14% of the stores in Englewood/West Englewood carried sweet potatoes vs. 12.5% Chicago Lawn/West Lawn, 10.4% New City, and 6.8% Brighton Park/Gage Park and 8.5% sold leafy greens (ex. collard greens, mustard greens) compared to 6.9% Chicago Lawn/West Lawn, 7.5% New City, and 6.8% Brighton Park/Gage Park. • Availability of Restaurants by Type Availability of Restaurants by Type Availability of Restaurants by Type Availability of Restaurants by Type We also conducted in-person audits at 60 restaurants in Englewood/West Engle-wood in 2007-2008. Assessments were conducted using a standard checklist of healthy/unhealthy food options. The majority of restaurants in Englewood/West Englewood were classified as local chain fast food (46.7%) (i.e. fast food restaurant based in Chicago with 3 or more locations) or non chain fast food (40%) (i.e. fast food restaurant based in Chicago with fewer than 3 locations). At the time of the as-sessment there were no full service restaurants located in the community. • Availability of Restaurant Food Options Availability of Restaurant Food Options Availability of Restaurant Food Options Availability of Restaurant Food Options The food options available at restaurants are highlighted in Figure 2. Fifty-eight per-cent of the restaurants carried bottled water and 33% served salads. Many of the restau-rants that provided salads were national/local chains. The most common foods served at restaurants in Englewood/West Englewood included fried chicken (73%), fried fish (61%), pizza puffs (56%), and Italian beef/Philadelphia cheese steak sandwiches (51%).

58.0%

33.3%

67.0% 73.3%56.0% 51.0%

Bottled Water

Salads Fried Fish Fried Chicken

Pizza Puff Beef/Steak

Figure 2: Availability of Select foods at Englewood Restaurants

% Restaurants w/Food Item

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Background: Neighborhood Food Availability

We also conducted a nutrient analysis of common entrees offered at restaurants in the community. Many of the entrees offered at restaurants in Englewood/West Englewood exceeded the recommended amounts of fat, sodium, and/or calories (based on a 2000 calorie diet). The nutrient contents of several common menu items are highlighted in Table 3.

• Restaurant and Store Environments Restaurant and Store Environments Restaurant and Store Environments Restaurant and Store Environments As part of the in-person audits of the stores and restaurants, we assessed factors that may be related to store quality, including the presence/absence of bulletproof glass, cleanliness, and advertisements for tobacco/alcohol products. In Englewood/West Engle-wood approximately half the stores (52%) had bulletproof glass compared to 12.3% in Brighton/Gage Park, 18% in Chicago Lawn/West Lawn and 25% in New City. Sixty-three percent of the restaurants in Englewood/West Englewood had bulletproof glass. Window ads for tobacco and alcohol in stores were similar across neighborhoods with the exception of Brighton Park/Gage Park, which had significantly fewer alcohol ads. Based on assessor ratings, the cleanliness of the stores in Englewood/West Englewood and Chicago Lawn/West Lawn were similar (48% and 53% rated as very/somewhat clean respectively). Comparatively, 93% of stores in Brighton Park/Gage Park and 86% of stores in New City were rated as very/somewhat clean.

Item Calories (kcals)

Total Fat (g)

Saturated Fat (g)

Sodium (mg)

Super Philly Steak Meal* 2223 83 27 2049

Fried Chicken Sandwich w/Fries 1089 59 9 1516

Small Catfish Dinner# 1669 71 16 3068

Pizza Puff w/Fries 1022 54 13 1390

Four Chicken Wing Dinner 1385 80 16 1955

Caesar Salad w/Dressing 659 22 5 1519

*Meal includes fries and frozen lemonade drink #Dinners served includes fries, coleslaw, and 2 slices of white bread Recommended Nutrient Intakes per day: Calories (2000 kcals); Total Fat (less than 65 g); Saturated Fat (less than 20 g); Sodium (African Americans recommended less than 1500 mg)

Table 3. Estimated Nutrient Contents of Common Menu Items at Englewood/West Englewood Restaurants

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Findings: Families Perceptions of Food and Marketing Environments

• Participants’ Food Access Participants’ Food Access Participants’ Food Access Participants’ Food Access Families obtained food from a variety of locations including chain supermarkets, dis-count chains, warehouse grocery stores, inde-pendent grocery stores, corner/convenience stores, dollar stores, pharmacies, informal stores (e.g.,home-based “candy” stores), meat markets, WIC food centers, job cafeterias, and food pantries. For major shopping trips, most participants used a combination of chain super-markets (such as Jewel and Fairplay) and dis-count chain/warehouse grocery stores (such as Aldi, Food for Less, and Sav-A-Lot). Participants mainly used convenience/corner stores to pur-chase snacks or certain staple items (e.g., bread, milk, juice) when they ran out. A few par-ticipants also mentioned going to meat mar-kets or independent grocers to buy large “meat packs” (a variety of meats packaged together and sold for a bargain price). Most participants purchased food from stores both inside and outside of their neighbor-hood. On average, participants used about 4 or 5 shopping locations to purchase food and traveled approximately 2 miles. However, shopping distance traveled by participants ranged from about 1/8th of a mile to a little over 10 miles. Participants traveled to/from and obtained food from stores using different modes of transportation including walking, obtaining rides from family/friends, driving, de-livery, public transportation, and formal/informal cabs. One participant also reported using a wagon to transport groceries. Fast food restaurants were the most common type of restaurant used by partici-pants (including national/local chain restaurants, non-chain restaurants, pizza carry-out,

sandwich shops, and Chinese food locations). Similar to stores, participants visited fast food restaurants both inside and outside their neighborhood. However, a greater percentage of restaurants visited by participants were located inside participants’ neighborhoods as compared to stores. Many participants reported walking to local restaurants, driving or obtaining rides to res-taurants outside the neighborhood, and having prepared foods delivered directly to their homes.

Similar to chain supermarkets, all buffet and full service restaurants used by participants were located outside their neighborhood. Participants’ individual resources including ac-

““““That store] is more like a little hole in That store] is more like a little hole in That store] is more like a little hole in That store] is more like a little hole in the wall but at the same time they have the wall but at the same time they have the wall but at the same time they have the wall but at the same time they have a lot of different things in there. Their a lot of different things in there. Their a lot of different things in there. Their a lot of different things in there. Their meat packages. Oh my God. It’s reason-meat packages. Oh my God. It’s reason-meat packages. Oh my God. It’s reason-meat packages. Oh my God. It’s reason-able prices. They’ll have a packet of able prices. They’ll have a packet of able prices. They’ll have a packet of able prices. They’ll have a packet of pork chops for $3, pounds of ground pork chops for $3, pounds of ground pork chops for $3, pounds of ground pork chops for $3, pounds of ground beef for like $4, chicken wing bags for beef for like $4, chicken wing bags for beef for like $4, chicken wing bags for beef for like $4, chicken wing bags for $5 and it’s just so good and fresh. It $5 and it’s just so good and fresh. It $5 and it’s just so good and fresh. It $5 and it’s just so good and fresh. It don’t be old. It don’t have a smell to it. don’t be old. It don’t have a smell to it. don’t be old. It don’t have a smell to it. don’t be old. It don’t have a smell to it. They put out fresh meat things every They put out fresh meat things every They put out fresh meat things every They put out fresh meat things every day.” day.” day.” day.”

Participant Shopping with Wagon

“I may go there and buy some pop or some-“I may go there and buy some pop or some-“I may go there and buy some pop or some-“I may go there and buy some pop or some-thing… You have to go to [the corner store] thing… You have to go to [the corner store] thing… You have to go to [the corner store] thing… You have to go to [the corner store] for some reason for some reason for some reason for some reason –––– and sometime I might and sometime I might and sometime I might and sometime I might even buy a loaf of bread from them. But as even buy a loaf of bread from them. But as even buy a loaf of bread from them. But as even buy a loaf of bread from them. But as far as like my meats, fruits and vegetables, far as like my meats, fruits and vegetables, far as like my meats, fruits and vegetables, far as like my meats, fruits and vegetables, I don’t buy it from them. ” I don’t buy it from them. ” I don’t buy it from them. ” I don’t buy it from them. ”

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cess to transportation, income/food assistance benefits, and employment location im-pacted the locations where they accessed food. For example, participants who worked outside of the community commonly reported accessing restaurants and stores near their place of em-ployment. • Perceived Food Availability Perceived Food Availability Perceived Food Availability Perceived Food Availability Consistent with the in-person audits, many families expressed concerns about the stores and products available in their neighbor-hood. Most concerns were related to the product availability and quality, specifically fruits and

vegetables. Several participants also expressed concerns about the quality of the meats sold in the neighborhood, indicating that several stores frequently carried spoiled meats. Although many partici-pants reported dissatisfaction with the food options available in stores, most were satisfied with the selection of foods avail-able in their neighborhood res-taurants. Participants reported that many of the foods sold at

their neighborhood were consistent with their taste preferences, budget and/or lifestyle. Participants also mentioned that they use fast food options when they are too tired or busy to cook, have extra money, or when their children request certain items. A few participants indicated a need for additional fast food restaurants in the community based on taste pref-erences and potentially to provide employment opportunities. Some participants reported a need for greater variety and healthier food options in the community, such as a full-service restaurant. Many of these participants expressed that they were already eating healthy diets and wanted more options closer to their home.

“ “ “ “ When you walk in this [store] you When you walk in this [store] you When you walk in this [store] you When you walk in this [store] you smell like ... some alley people. smell like ... some alley people. smell like ... some alley people. smell like ... some alley people. Like four people that ain’t washed Like four people that ain’t washed Like four people that ain’t washed Like four people that ain’t washed their booty just sitting in the back their booty just sitting in the back their booty just sitting in the back their booty just sitting in the back cutting your meat. You see this cutting your meat. You see this cutting your meat. You see this cutting your meat. You see this man and he ain’t never washed man and he ain’t never washed man and he ain’t never washed man and he ain’t never washed his hands. He just came outside his hands. He just came outside his hands. He just came outside his hands. He just came outside from falling and he came right from falling and he came right from falling and he came right from falling and he came right here and just cut your ground here and just cut your ground here and just cut your ground here and just cut your ground beef. Mm, mmm, it ain’t USDA ” beef. Mm, mmm, it ain’t USDA ” beef. Mm, mmm, it ain’t USDA ” beef. Mm, mmm, it ain’t USDA ”

“You go all the way out to the suburbs where the “You go all the way out to the suburbs where the “You go all the way out to the suburbs where the “You go all the way out to the suburbs where the white people live at and you find everything…It’s white people live at and you find everything…It’s white people live at and you find everything…It’s white people live at and you find everything…It’s even a better variety in [chain supermarkets] when even a better variety in [chain supermarkets] when even a better variety in [chain supermarkets] when even a better variety in [chain supermarkets] when you go to their stores. There’s a difference.”you go to their stores. There’s a difference.”you go to their stores. There’s a difference.”you go to their stores. There’s a difference.”

Findings: Families Perceptions of Food and Marketing Environments

14

Findings: Families Perceptions of Food and Marketing Environments

• Price Matters Price Matters Price Matters Price Matters Cost was also frequently mentioned in connection with food availability. Many participants indicated that they shopped at discount food stores, purchased in bulk, or looked for sales to make ends meet. Partici-pants also reported that price was a factor when purchasing food from restaurants. Par-ticipants indicated that many of the restau-rants in their area offered specials and that they took advantage of these deals when they had money available. • Do Race and Income Matter?Do Race and Income Matter?Do Race and Income Matter?Do Race and Income Matter? Several participants raised concerns about the lack of African American owned stores/restaurants in the their community. These concerns were expressed both in the con-text of the need for more “black” owned stores overall, as well as in response to negative interactions with Arab American store owners. The lack of African Americans hired to work in Arab Ameri-can owned stores was also raised as an issue. Most participants felt that the conflict between Arab Ameri-can owners and African American residents was caused by owners’ lack of respect for the community which resulted in stores providing poor customer service, “jack up” prices, and low quality foods; while a few participants attributed some of the blame to unruly custom-

ers. Some partici-pants mentioned that Arab-American store owners that have a long history in the neighborhood, help people in the neighborhood, and/or embrace African

American culture have a better reputation in the community compared to others. These owners were also reported by a few participants to sell better quality products because of community concern. One participant also mentioned that she felt the lack of grocery stores was a sign of the city’s interest in driv-ing low-income families out of the neighborhood to make room for higher income housing and residents.

““““The Arabs The Arabs The Arabs The Arabs ---- how they talk to you. how they talk to you. how they talk to you. how they talk to you. And you know…. I ain’t going let ’ And you know…. I ain’t going let ’ And you know…. I ain’t going let ’ And you know…. I ain’t going let ’ em talk to me like that ”em talk to me like that ”em talk to me like that ”em talk to me like that ”

“[That restaurant], They’re cheap. You “[That restaurant], They’re cheap. You “[That restaurant], They’re cheap. You “[That restaurant], They’re cheap. You can get two jumbo pizzas for $20. I can get two jumbo pizzas for $20. I can get two jumbo pizzas for $20. I can get two jumbo pizzas for $20. I have a lot of boys and they eat a lot “have a lot of boys and they eat a lot “have a lot of boys and they eat a lot “have a lot of boys and they eat a lot “

“ Well, number one I would close down the corner stickup but like “ Well, number one I would close down the corner stickup but like “ Well, number one I would close down the corner stickup but like “ Well, number one I would close down the corner stickup but like the saying goes, Throughout the city of Chicago most corner stores the saying goes, Throughout the city of Chicago most corner stores the saying goes, Throughout the city of Chicago most corner stores the saying goes, Throughout the city of Chicago most corner stores are run by Arabs or Koreans. I don’t know what happened to the are run by Arabs or Koreans. I don’t know what happened to the are run by Arabs or Koreans. I don’t know what happened to the are run by Arabs or Koreans. I don’t know what happened to the black community. We just don’t have the finances or we can’t have black community. We just don’t have the finances or we can’t have black community. We just don’t have the finances or we can’t have black community. We just don’t have the finances or we can’t have the intelligence to go get them corner lots or we’re fearful of the the intelligence to go get them corner lots or we’re fearful of the the intelligence to go get them corner lots or we’re fearful of the the intelligence to go get them corner lots or we’re fearful of the competition or what have you. But everybody says that when Arabs competition or what have you. But everybody says that when Arabs competition or what have you. But everybody says that when Arabs competition or what have you. But everybody says that when Arabs come over here and Koreans come over here the government gives come over here and Koreans come over here the government gives come over here and Koreans come over here the government gives come over here and Koreans come over here the government gives them free money, free this and free that and then they got one leg them free money, free this and free that and then they got one leg them free money, free this and free that and then they got one leg them free money, free this and free that and then they got one leg up because they’ve got the money.” up because they’ve got the money.” up because they’ve got the money.” up because they’ve got the money.”

“There aren’t any grocery stores in this “There aren’t any grocery stores in this “There aren’t any grocery stores in this “There aren’t any grocery stores in this neighborhood because nine times out of ten neighborhood because nine times out of ten neighborhood because nine times out of ten neighborhood because nine times out of ten they probably had plans on getting rid of the they probably had plans on getting rid of the they probably had plans on getting rid of the they probably had plans on getting rid of the neighborhood.” neighborhood.” neighborhood.” neighborhood.”

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Findings: Families Perceptions of Food and Marketing Environments

• Marketing and Advertising Marketing and Advertising Marketing and Advertising Marketing and Advertising Participants indicated that they obtained infor-mation about food from several sources including television, newspapers/store circular ads, flyers, bill-boards, window ads, in-store promotions, and word of mouth. Television was a major source of exposure to advertising. Several of the participants recalled com-mercials that advertise deals and special pricing at both stores and restaurants. While commercials were commonly mentioned as being entertaining, many participants did not believe that they had a direct in-fluence on their purchasing behaviors. However, some participants mentioned that adver-

tising indirectly impacts their purchases by en-couraging their children to request or eat certain foods. Participants indicated that these ads com-monly feature characters, colors, animation or special effects that appeal to children and chil-dren ask for these products as soon as they see them. Most participants purchased products based on information they received from store circulars, window ads at restaurants, and news-

papers. Participants reported using these channels to learn about weekly/daily promotions and sales. Several participants used this information to locate sales/specials on brand name products. In addition, although many of the participants reported purchasing store brands to save money, name brands were preferred for certain products based on family preferences, familiarity or family traditions. Another issue raised by participants related to marketing was the type of products promoted in low-income and African American neighborhoods. A few participants expressed concerns about differences in store layouts, specifically the types of products located in the front of the store at retail locations in their neighbor-hood compared to stores in predominately white/Latino neighborhoods.

“They put a big size burger in your “They put a big size burger in your “They put a big size burger in your “They put a big size burger in your face or the nice crispy chicken nug-face or the nice crispy chicken nug-face or the nice crispy chicken nug-face or the nice crispy chicken nug-gets on TV and then when they’re gets on TV and then when they’re gets on TV and then when they’re gets on TV and then when they’re done and they say, ‘We lovin’ it.’ done and they say, ‘We lovin’ it.’ done and they say, ‘We lovin’ it.’ done and they say, ‘We lovin’ it.’ That’s it. That’s all they give you is, That’s it. That’s all they give you is, That’s it. That’s all they give you is, That’s it. That’s all they give you is, ‘We lovin’ it’ and the kids say, ‘We lovin’ it’ and the kids say, ‘We lovin’ it’ and the kids say, ‘We lovin’ it’ and the kids say, ‘We’re lovin’ it’ and they’re just, ‘We ‘We’re lovin’ it’ and they’re just, ‘We ‘We’re lovin’ it’ and they’re just, ‘We ‘We’re lovin’ it’ and they’re just, ‘We want McDonald’s, we want McDon-want McDonald’s, we want McDon-want McDonald’s, we want McDon-want McDonald’s, we want McDon-ald’s.’ So that’s where we take ald’s.’ So that’s where we take ald’s.’ So that’s where we take ald’s.’ So that’s where we take them tothem tothem tothem to———— McDonald’s.” McDonald’s.” McDonald’s.” McDonald’s.”

“[In other communities] you see “[In other communities] you see “[In other communities] you see “[In other communities] you see the vegetables when you first go the vegetables when you first go the vegetables when you first go the vegetables when you first go in. You see the fruit when you first in. You see the fruit when you first in. You see the fruit when you first in. You see the fruit when you first go in. You’re not looking at the go in. You’re not looking at the go in. You’re not looking at the go in. You’re not looking at the Flamin’ Hots and all that stuff Flamin’ Hots and all that stuff Flamin’ Hots and all that stuff Flamin’ Hots and all that stuff which I can’t stand… I see myself which I can’t stand… I see myself which I can’t stand… I see myself which I can’t stand… I see myself just going into different grocery just going into different grocery just going into different grocery just going into different grocery stores especially in the African stores especially in the African stores especially in the African stores especially in the African American community that [the me-American community that [the me-American community that [the me-American community that [the me-dia] is the key. It’s the cake, it’s the dia] is the key. It’s the cake, it’s the dia] is the key. It’s the cake, it’s the dia] is the key. It’s the cake, it’s the chips, it’s the soda… then you have chips, it’s the soda… then you have chips, it’s the soda… then you have chips, it’s the soda… then you have to hunt for the fruits, the vegeta-to hunt for the fruits, the vegeta-to hunt for the fruits, the vegeta-to hunt for the fruits, the vegeta-bles, the bottled water, and things bles, the bottled water, and things bles, the bottled water, and things bles, the bottled water, and things like that.”like that.”like that.”like that.”

“...when you first walk in, you ain’t got noth-“...when you first walk in, you ain’t got noth-“...when you first walk in, you ain’t got noth-“...when you first walk in, you ain’t got noth-ing but the junk food… You’d about spend ing but the junk food… You’d about spend ing but the junk food… You’d about spend ing but the junk food… You’d about spend all your stamps on junk food cause you ain’t all your stamps on junk food cause you ain’t all your stamps on junk food cause you ain’t all your stamps on junk food cause you ain’t even got to the meat and stuff. You still even got to the meat and stuff. You still even got to the meat and stuff. You still even got to the meat and stuff. You still over here in [the front] aisle…. I went to [the over here in [the front] aisle…. I went to [the over here in [the front] aisle…. I went to [the over here in [the front] aisle…. I went to [the same store] on 87th and Cicero and they same store] on 87th and Cicero and they same store] on 87th and Cicero and they same store] on 87th and Cicero and they don’t have it like that. They don’t have the don’t have it like that. They don’t have the don’t have it like that. They don’t have the don’t have it like that. They don’t have the junk right there. It’s like you gotta find it. junk right there. It’s like you gotta find it. junk right there. It’s like you gotta find it. junk right there. It’s like you gotta find it. You walk in there. They got the frozen sec-You walk in there. They got the frozen sec-You walk in there. They got the frozen sec-You walk in there. They got the frozen sec-tion; they have bread, the can goods.” tion; they have bread, the can goods.” tion; they have bread, the can goods.” tion; they have bread, the can goods.”

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Findings: Families Perceptions of Food and Marketing Environments

• Other Issues Other Issues Other Issues Other Issues Although the focus of this research was on neighborhood food availability, partici-pants commonly mentioned other factors that influence food access that were not directly related to food products. These included the store environment (such as poor upkeep and customer service) and issues surrounding retail outlets (including community violence). Poor upkeep was viewed as a sign of food and food-outlet quality. Poor upkeep was particularly raised in reference to stores in the neighborhood and included lack of cleanliness, disorganized shelves and aisles, and poorly maintained shopping carts. With respect to cleanliness, participants reported that foul odors, dirty un-mopped floors and cockroaches and rodents turned them off. Besides these obvious signs, participants also judged cleanliness and store quality based on whether they saw employees cleaning or at-tending to customer spills promptly, engaging in inappropriate behaviors while handling food (e.g. smoking) and bathroom maintenance. In addition, several participants reported avoiding certain outlets based on safety con-cerns. Many safety concerns stemmed from prob-lems with people hanging out in front of stores, panhandling, soliciting drugs, and harassing shoppers. The proximity of liquor stores to some stores and restaurants was seen as con-tributing to the problem.

“About the neighborhood store? Well, I “About the neighborhood store? Well, I “About the neighborhood store? Well, I “About the neighborhood store? Well, I hate the stores where you can go. hate the stores where you can go. hate the stores where you can go. hate the stores where you can go. They let the kids just hang in the store They let the kids just hang in the store They let the kids just hang in the store They let the kids just hang in the store and they ain’t buying nothing, they and they ain’t buying nothing, they and they ain’t buying nothing, they and they ain’t buying nothing, they should make them go right ahead should make them go right ahead should make them go right ahead should make them go right ahead ---- the the the the crowd that hang out in front of them.”crowd that hang out in front of them.”crowd that hang out in front of them.”crowd that hang out in front of them.”

“A lot of restaurants I don’t eat out of. “A lot of restaurants I don’t eat out of. “A lot of restaurants I don’t eat out of. “A lot of restaurants I don’t eat out of. Especially on 69Especially on 69Especially on 69Especially on 69thththth and Racine cause and Racine cause and Racine cause and Racine cause that’s where a lot of hanging out and that’s where a lot of hanging out and that’s where a lot of hanging out and that’s where a lot of hanging out and wild noise and everybody hang out up wild noise and everybody hang out up wild noise and everybody hang out up wild noise and everybody hang out up there.”there.”there.”there.”

“If [the bathroom] is dirty I won’t shop “If [the bathroom] is dirty I won’t shop “If [the bathroom] is dirty I won’t shop “If [the bathroom] is dirty I won’t shop there. That’s usually the first thing. Be-there. That’s usually the first thing. Be-there. That’s usually the first thing. Be-there. That’s usually the first thing. Be-cause I’m pregnant and so I’ve always got cause I’m pregnant and so I’ve always got cause I’m pregnant and so I’ve always got cause I’m pregnant and so I’ve always got to go to the bathroom. So that’s the first to go to the bathroom. So that’s the first to go to the bathroom. So that’s the first to go to the bathroom. So that’s the first thing that I do is go to the bathroom and thing that I do is go to the bathroom and thing that I do is go to the bathroom and thing that I do is go to the bathroom and then I go grocery shopping. If it’s dirty in then I go grocery shopping. If it’s dirty in then I go grocery shopping. If it’s dirty in then I go grocery shopping. If it’s dirty in there then I’m like ‘I ain’t going, not to-there then I’m like ‘I ain’t going, not to-there then I’m like ‘I ain’t going, not to-there then I’m like ‘I ain’t going, not to-day.”day.”day.”day.”

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Potential Solutions: Participant Recommendations

• RecommendationsRecommendationsRecommendationsRecommendations Participants made several recommendations for policy and community action to ex-pand food access in their community including regulating the content of foods served at restaurants, offering incentives for healthy food retail and community gardens, starting their own food-related business, changing perceptions of the neighborhood, and bringing in new businesses to create competition for existing retail stores. During the interviews, par-ticipants were asked, “If you were an Alderman or advisor to Mayor Daley, what would you do to change your community?” Responses focused on improving overall community needs such as reducing violence and crime, and improving neighborhood aesthetics, as well as links between these issues and the food options available in their neighborhood. Examples of these recommendations are highlighted in Table 4:

Participant Recommendation Example

Reduce Neighborhood Crime and Violence to Attract More Food Retail Options

Well, you know around here it’s kind of bad. If they cut down on the crime rates they probably might get some more stores here. It’s kind of bad around here.

Offer Tax Incentives to Attract Businesses to the City of Chicago

Maybe they could restructure some of the taxes and stuff in the city and then more businesses will come back to the city.

Change Food Retailers’ Perceptions of People that live in South Side Neighborhoods

You’d still have to change people’s per-ceptions. Business owners’ perceptions of the people in this neighborhood.

Improve the Physical Appearance of Existing Retail Food Stores and Increase Safety

I would change the environment or re-modeling the front building to make it look more suitable and safe that you can walk in and walk out without a problem. I would keep security around. I’d keep a good environment.

Improve Customer Service through Hiring Experienced Employees and Bet-ter Training

I would hire people that had more people skills and that are used to working around people and don’t have attitudes with other customers and stuff…[People who] know how to hold yourself in a re-spectable manner. [And that know] you can treat people with the same respect that you want them to treat you with.

Table 4. Participant Recommendations to Change Neighborhood Food Availability in South Side Communities

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Potential Solutions: Participant Recommendations

Participant Recommendation Example:

Regulate Nutritional Content of Foods Served in Restaurants

Do like they did in New York City. Come up with across the board city controlled value for how much fat and carbohy-drates goes into your food. They got that in New York City whereas they come around and check to make sure you ain’t got all this high carbohydrates and such that you done put on to fatten people [so] they go into an obesity syn-drome… Eventually, they’re going to get it in Chicago where the people ain’t going to be just putting anything on your food. They going to make a book. They going to make you think health wise.

Create Competition by Bringing in New Retail Stores

I wish they had a Pete’s Produce right here on 63rd Street. As a matter of fact, right there across the street there in between Aldi’s and Walgreen’s would be a nice place for it. Yep. Of course, Aldi’s wouldn’t like it because they wouldn’t hardly sell any of their produce but that would make them step their game up. They’d have to do something different.

Inform Policymakers about the Lack of High Quality Products in the Neighbor-hood and the Impact of Those Products on Health

I would try to tell them the variety and the freshness of the product is more healthy for our peoples in this neighbor-hood instead of the stuff that they got over here. It’s not very healthy for to keep up good strong bones and every-thing that a person needs to survive. The food is not fresh and it’s not up to standard as in other neighborhoods. It’s not up to standard. So that’s about all I can tell’ em. It’s not up to standard compared to other neighborhoods. Our products is not like the other ones. That’s why a lot of peoples that got transportation go to them stores in the other neighborhoods because it’s better for the kids.

Table 4 continued. Participant Recommendations to Change Neighborhood Food Availability in South Side Communities

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Potential Solutions: Lessons from the Food Tour

• After visiting each store, participants who completed the “Food Tour” reported specific recommendations related to store-environment and product selection. Participants dis-cussed positive and negative aspects of the stores. Recommendations from the food tour participants are described in Table 5.

Participant Recommendation Example:

Food Retail Stores that Provide More Variety

What I liked about Bob’s was the variety. It had a variety of foods there for you to try. I mean either to try or try for your family just as far as your fruits and vegetables and dif-ferent meats…. That’s what I think is real nice about these is that they have a good va-riety of stuff that you don’t find in the mom and pop stores.

Food Retail Stores with Highly Trained Employees that Maintain a Clean and Well Stocked Store Environment

… everybody works their hours and they start at the vegetables and fruits. They start at this one aisle and they work all the way through that whole day because that’s what you’re doing making sure everything is still stocked. If a piece is taken out they put an-other piece back in real quick.

Food Retail Stores that Provide High Quality Products

They’ve got some nice stuff here. It’s real nice. How does this compare? I wouldn’t even put [neighborhood stores] in the same rank as this store. No, man. The stores that I go to is like a thrift store compared to this store.

Food Retail Stores that Provide High Quality Food at a Reasonable Cost

This stuff here man, this is good food, good prices. Usually, when you walk into a store in the hood it smells. You get that stench from where the fruits and stuff have been up there for a while and you can smell it. I walk in the door here, it smells good. I was like, wow. It’s a nice environment here. I like it.

Food Retail Stores with Other Amenities Such as Delivery Services

I might let my mama know about coming up here to shop up here sometimes. Do they deliver. Do they have delivery people out there?

Food Retail Stores that Do Not Engage in Unfair/Racist Monitoring Practices of Customers

I was at the ATM getting some money and it kept beeping and like all of a sudden two or three security officers were right around. They acted like they wasn’t watching me but I could tell they were as if I did something.

Table 5. Participant Recommendations During a Tour of Three Supermarkets/Grocery Stores Outside the Neighborhood

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Conclusion/Implications

In the last decade, increasing attention has been given to the need for better food and marketing environments in low-income and communities of color. Although many stud-ies have examined these issues from the perspective of researchers, advocates, and policy-makers, few have focused on understanding the perceptions of community residents. Par-ticipants in this study mentioned several concerns related to food access and neighbor-hood food availability. These issues focused specifically on the types and quality of food retailers and options available, as well as other issues, such as marketing/advertising, cus-tomer service, and neighborhood safety. This report demonstrates that community resi-dents have clear recommendations for community action and policy change including at-tracting new retail options and improving the selection/variety, customer service, and aes-thetics of existing retail outlets. Nationally, a number of community/policy efforts have been proposed to address food access and marketing concerns, particularly in minority and low-income communities. Initiatives proposed include: • Taxes (sugar-sweetened beverages) • Subsidies/incentives (fruits and vegetables for families; retail development) • Limiting access to unhealthy products/zoning (fast food zoning; fast food toy ban; com-

munity gardens) • product information (menu labeling) • Local business development (mobile vendors/green arts) It is not clear if all of the issues raised by participants in this study, specifically safety, un-fair treatment, and minority business development, will be addressed by these efforts. The work of policymakers, community leaders, advocates, and researchers need to be informed by members of the communities who are most at risk for low food access. In addition, once policy and community efforts are implemented, the impact of these strategies on the health and well-being of African American individuals and families needs to be considered.